The Norman Transcript

Columns

August 15, 2013

This will sting a little bit

NORMAN — Hospitals across the country could find themselves in a financial squeeze next year thanks to federal health care reform.

The 2010 Patient Protection and Affordable Care Act, known as Obamacare, is cutting hospitals' reimbursements from Medicare — the federal program that provides health care to the elderly — by $155 billion.

When the law was passed, hospital officials agreed to the cut believing that patients covered by the new law who previously had been uninsured would more than make up the difference.

But hospital officials are growing increasingly worried as it becomes apparent the law will not expand health care to as many people as they had hoped.

The law required states to expand Medicaid — the federal and state program that provides health coverage to those with low incomes — to individuals earning up to 133 percent of the federal poverty level.

That alone was expected to provide coverage to 17 million Americans who didn’t have coverage.

But last year the U.S. Supreme Court, while upholding most of the Affordable Care Act, also said Congress could not require states to expand Medicaid.

Now roughly half the states, including Georgia and Oklahoma, do not plan to expand Medicaid coverage, with leaders in most citing concerns about long-term costs.

The Affordable Care Act also set up exchanges for those who don’t have coverage through work or government programs to buy insurance.

To encourage people to use the exchanges, the law created carrots — subsidies for those under certain income levels — as well as sticks — a $95 fine on tax refunds for not having coverage.

The Congressional Budget Office estimates that next year 6 million uninsured people will chance a fine on their tax refunds rather than buy health coverage.

So as hospitals face the certainty of lower Medicare reimbursements and more regulation, it’s looking less likely that the number of uninsured patients they treat will change. That has the potential to hit them hard.

And it’s what happens when Congress passes a sweeping law aimed at fundamentally changing one of the largest sectors of the economy.

The law counted on all parts working exactly as supporters had hoped.

Government rarely works that way, however, and those who voted for the law should have known it. Their hubris blinded them.

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